대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제54권1호
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  • Pages.49-56
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  • 2016
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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과도한 마모를 보이는 환자에서, 임플란트를 활용해 수직 고경을 증가시키며 shortened dental arch 개념을 적용한 보철 수복 증례

Using implants for worn dentition with the altered vertical dimension of occlusion based on shortened dental arch concept: a case report

  • 이재현 (가톨릭대학교 의과대학 서울성모병원 치과보철과) ;
  • 김태수 (가톨릭대학교 의과대학 서울성모병원 치과보철과) ;
  • 이철원 (가톨릭대학교 의과대학 서울성모병원 치과보철과) ;
  • 이원섭 (가톨릭대학교 의과대학 서울성모병원 치과보철과) ;
  • 이수영 (가톨릭대학교 의과대학 서울성모병원 치과보철과)
  • Lee, Jae Hyun (Department of Prosthodontics, Seoul St. Mary's Hospital, Catholic University of Korea) ;
  • Kim, Tae Su (Department of Prosthodontics, Seoul St. Mary's Hospital, Catholic University of Korea) ;
  • Lee, Chul Won (Department of Prosthodontics, Seoul St. Mary's Hospital, Catholic University of Korea) ;
  • Lee, Won Sup (Department of Prosthodontics, Seoul St. Mary's Hospital, Catholic University of Korea) ;
  • Lee, Su Young (Department of Prosthodontics, Seoul St. Mary's Hospital, Catholic University of Korea)
  • 투고 : 2015.07.29
  • 심사 : 2015.08.26
  • 발행 : 2016.01.29
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초록

과도한 마모 같은 잔존 치아 구조의 파괴는 전치유도와 저작 기능에 심각한 손상을 초래할 수 있다. 이런 증상을 개선시키기 위해서는 상실된 구치부를 수복하여 적절한 교합을 회복시켜주는 것이 필수적이다. 구치부의 무치악부를 수복하기 위해서는 의치나 임플란트가 사용될 수 있는데, 임플란트로 수복시에는 경제적인 제약으로 위해 shortened dental arch 개념을 적용하는 것이 유리할 수 있다. 본 증례는 86세 남환으로, 다수의 치아가 상실되어 있었고, 구치부 교합의 붕괴와 과도한 치질 소실, 수직 피개를 관찰할 수 있었다. 구치부에서 붕괴된 교합을 재형성해주는 것을 최우선 과제로 정하였으며, 가철성 보철물 대신, 국민건강보험이 적용된 2개의 임플란트와 고정성 국소의치, 레진을 이용하여 보철 수복을 완료하였다. 소구치 부위에서 2 mm의 수직고경을 거상하였으며, shortened dental arch 개념을 적용하였다. 이를 통해 전악 수복에 비하여 적은 비용으로 이를 대체하는 치료를 고정성 보철물로 할 수 있었으며, 심미적, 기능적으로 양호한 결과를 얻었다.

Excessive occlusal wear can result in unacceptable damage to the residual teeth structure, anterior guidance and masticatory function. An 86-year-old man presented with worn dentition and anterior deep bite due to loss of the posterior support. Two implants covered by Korean national health insurance, fixed partial denture and direct composite resin were used to restore the dentition, instead of removable prosthesis. The occlusal vertical dimension was increased by 2 mm in the premolar area and shortened dental arch concept was applied. This treatment was a less expensive alternative to full-mouth rehabilitation with positive esthetic and functional outcomes after 7 months of follow-up.

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